HFMA METRO NEW YORK
Early Careerist Mentee Application
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Name ______Title ______Organization ______
Preferred Email Address ______Preferred Contact Number ______
University Affiliation ______
How long have you been an HFMA member? ______
How long have you been in the healthcare finance profession?______
1. Please list three (3) goals that you would like to reach as a result of a mentor/mentee
relationship?
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2. What career milestones do you want to reach in the next two years? (short term).
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3. What resources and knowledge do you need to accomplish this goal?
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4. What characteristics are you looking for in a mentor?
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5. What are some developmental areas that you would like to discuss with your mentor?
Career Planning Management Skills Networking Skills
Interpersonal Skills Specific Healthcare Management Subject Matter ______
(Page 2)
6. Please list your work related accomplishments:______
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7. Please comment on why you should be selected for the mentor program:
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Please return application to:
Early Careerist Mentor Toolkit